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1997-2017 年,与阿根廷西北部气候多变相关的汉坦病毒肺综合征疫情爆发。

Hantavirus pulmonary syndrome outbreaks associated with climate variability in Northwestern Argentina, 1997-2017.

机构信息

Instituto de Ecorregiones Andinas-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Universidad Nacional de Jujuy (UNJu), San Salvador de Jujuy, Argentina.

Instituto Nacional de Enfermedades Infecciosas (INEI), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) "Dr. C. G. Malbrán", Buenos Aires, Argentina.

出版信息

PLoS Negl Trop Dis. 2020 Nov 30;14(11):e0008786. doi: 10.1371/journal.pntd.0008786. eCollection 2020 Nov.

Abstract

BACKGROUND

Rodent-borne hantaviruses (genus Orthohantavirus) are the etiologic agents causing two human diseases: hemorrhagic fever with renal syndrome (HFRS) in Euroasia; and hantavirus pulmonary syndrome (HPS) in North and South America. In South America fatality rates of HPS can reach up to 35%-50%. The transmission of pathogenic hantaviruses to humans occurs mainly via inhalation of aerosolized excreta from infected rodents. Thus, the epidemiology of HPS is necessarily linked to the ecology of their rodent hosts and the contact with a human, which in turn may be influenced by climatic variability. Here we examined the relationship between climatic variables and hantavirus transmission aim to develop an early warning system of potential hantavirus outbreaks based on ecologically relevant climatic factors.

METHODOLOGY AND MAIN FINDINGS

We compiled reported HPS cases in northwestern Argentina during the 1997-2017 period and divided our data into biannual, quarterly, and bimestrial time periods to allow annual and shorter time delays to be observed. To evaluate the relationship of hantavirus transmission with mean temperature and precipitation we used dynamic regression analysis. We found a significant association between HPS incidence and lagged rainfall and temperature with a delay of 2 to 6 months. For the biannual and quarterly models, hantavirus transmission was positively associated with lagged rainfall and temperature; whereas the bimestrial models indicate a direct relationship with the rainfall but inverse for temperature in the second lagged period.

CONCLUSIONS/SIGNIFICANCE: This work demonstrates that climate variability plays a significant role in the transmission of hantavirus in northwestern Argentina. The model developed in this study provides a basis for the forecast of potential HPS outbreaks based on climatic parameters. Our findings are valuable for the development of public health policies and prevention strategies to mitigate possible outbreaks. Nonetheless, a surveillance program on rodent population dynamics would lead to a more accurate forecast of HPS outbreaks.

摘要

背景

啮齿动物传播的汉坦病毒(正呼肠孤病毒属)是引起两种人类疾病的病原体:欧亚大陆的肾综合征出血热(HFRS);以及南北美洲的汉坦病毒肺综合征(HPS)。在南美洲,HPS 的死亡率可达 35%-50%。致病性汉坦病毒向人类的传播主要通过吸入感染啮齿动物的气溶胶化排泄物来实现。因此,HPS 的流行病学必然与宿主啮齿动物的生态学以及与人类的接触有关,而这又可能受到气候变异性的影响。在这里,我们研究了气候变量与汉坦病毒传播之间的关系,旨在基于与生态相关的气候因素开发潜在汉坦病毒爆发的预警系统。

方法和主要发现

我们整理了 1997 年至 2017 年期间在阿根廷西北部报告的 HPS 病例,并将我们的数据分为半年度、季度和双月度时间段,以便观察年度和较短时间的滞后。为了评估汉坦病毒传播与平均温度和降水的关系,我们使用了动态回归分析。我们发现 HPS 发病率与滞后降雨和温度之间存在显著关联,滞后时间为 2 至 6 个月。对于半年度和季度模型,汉坦病毒传播与滞后降雨和温度呈正相关;而双月度模型表明,降雨与传播呈直接关系,但在第二个滞后期,温度呈反比关系。

结论/意义:这项工作表明,气候变异性在阿根廷西北部汉坦病毒的传播中起着重要作用。本研究中建立的模型为基于气候参数预测潜在 HPS 爆发提供了基础。我们的发现对于制定公共卫生政策和预防策略以减轻可能的爆发具有重要价值。然而,对啮齿动物种群动态的监测计划将导致对 HPS 爆发的更准确预测。

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